Contribution of SuPAR for Patients in a Situation of Uncertainty Downstream of Emergencies (SuPAR)

In this study, the investigators will investigate the relationship between the blood level of SuPAR at admission to the emergency department of the Clermont-Ferrand University Hospital, and the outcome of patients after their hospitalization in a short stay unit.

Study Overview

• Status: Completed
• Conditions: Disease; Emergencies; In-hospital Observation
• Intervention / Treatment: Other: blood supar measurement

Detailed Description

SuPAR (Soluble urokinase Plasminogen Activator Receptor) is a non-specific prognostic blood biomarker related to inflammation. An elevated SuPAR value reflects significant chronic inflammation and predicts a risk of negative outcome and even short-term mortality (intra-hospital, 30 days, 90 days). Conversely, a low SuPAR value is a strong indicator of good prognosis and low risk of readmission. It is therefore of interest to know a patient's SuPAR blood level to enable the clinician to decide whether the patient should be admitted or discharged. SuPAR has been shown to be the best prognostic marker associated with the presence and progression of disease and risk of mortality. The use of SuPAR in clinical routine adds significant complementary information to the standard Early Warning Score assessment and to the classical parameters such as CRP, PCT, Lactate, ALT, Bilirubin, and CBC in the pre-admission of acute patients.

Patients admitted to the emergency department will receive their usual management. We will test the added value of the SuPAR assay in the prognosis of patients' outcome at discharge.

• Study Type: Observational
• Enrollment (Actual): 202

Contacts and Locations

Study Locations

• France
  • Clermont-Ferrand, France
    • Chu Clermont-Ferrand

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

all patients requiring clinical observation for a final referral decision and meeting the eligibility criteria will be offered the study

Description

Inclusion Criteria:

• Patient, male or female, over 18 years old
• Admitted to the emergency department of the Clermont-Ferrand University Hospital for a medical reason,
• Classified as FRENCH II or III by the nurse organizer of the reception management
• Necessity of clinical observation in the Short Term Hospitalization Unit for final orientation decision
• Requires a blood test upon arrival in the emergency department
• Able to give informed non-opposition to participate in the research.
• Affiliation to a Social Security system

Exclusion Criteria:

• Patient under guardianship or curatorship
• Pregnant and breast feeding woman
• Patient admitted for psychiatric pathology
• Patient with a limitation of therapeutics
• Refusal to participate
• Patient hospitalized because of a particular social context

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Retrospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Experimental; Retrospective analysis of the correlation between SuPAR measurement and patient outcome after hospitalization	Other: blood supar measurement; The supar values will be measured afterwards on the tube bottoms of the patients included in the study from their usual collection

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Relationship between blood supar levels and patient outcome at discharge	Relation between blood supar levels measured and patient outcome at discharge evaluated as : return home = good evolution; hospitalization = bad evolution; admission to an intensive care unit or death = unfavorable evolution	When the excepted 150 patients will be included, estimated 6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
National Early Warning Score 2 (NEWS2)	Score allowing the classification of the urgency of a patient. The minimum value is 0 and the maximum value is 20. Higher scores mean a worse outcome	Hour 0
Modified Early Warning Score (MEWS)	Score allowing the classification of the urgency of a patient. The minimum value is 0 and the maximum value is 17. Higher scores mean a worse outcome	Hour 0
Blood supar levels	the supar values are classifies into three categories : < 3 ng/ml : supports the referral decision. the patient's general condition is good and the prognosis is high 3-6 ng/ml : presence of pathologies and comorbidity factors. readmissions and high mortality beyond 6 months >6 ng/ml : requires special clinical attention, high risk of mortality	When the excepted 150 patients will be included, estimated 6 months
Blood CRP value	the CRP value will be assessed during the blood test performed as part of the classical management when the patient arrives in the emergency room	Hour 0
Cardiac frequency	cardiac frequency will be evaluated when the patient arrives in the emergency service as part of the classical management	Hour 0
Respiratory rate	respiratory rate will be evaluated when the patient arrives in the emergency service as part of the classical management	Hour 0
Temperature	the temperature will be evaluated when the patient arrives in the emergency service as part of the classical management	Hour 0
Systolic blood pressure	systolic blood pressure will be evaluated when the patient arrives in the emergency service as part of the classical management	Hour 0
Diastolic blood pressure	diastolic blood pressure will be evaluated when the patient arrives in the emergency service as part of the classical management	Hour 0
French triage	French Emergency Nurses Classification in Hospitals (FRENCH) ranks priorities from 5 to 1 (from least urgent to most urgent) according to prognosis and complexity/severity of the medical condition	Hour 0
Main diagnosis retained by the physician	Main diagnosis retained	at the end of hospitalization

Collaborators and Investigators

• Sponsor: University Hospital, Clermont-Ferrand
• Investigators: Principal Investigator: Fares MOUSTAFA, University Hospital, Clermont-Ferrand

Study record dates

Study Major Dates

• Study Start (Actual): January 10, 2022
• Primary Completion (Actual): April 18, 2022
• Study Completion (Actual): April 18, 2022

Study Registration Dates

• First Submitted: December 8, 2021
• First Submitted That Met QC Criteria: January 27, 2022
• First Posted (Actual): January 28, 2022

Study Record Updates

• Last Update Posted (Actual): March 13, 2023
• Last Update Submitted That Met QC Criteria: March 10, 2023
• Last Verified: November 1, 2021

More Information

Terms related to this study

• Keywords: Emergency; Supar; Patient triage
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: RNI 2021 MOUSTAFA; 2021-A01930-41 (Other Identifier: 2021-A01930-41)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No